ITP Mom

[kaytlin]

Hi kthomps7,

We do have preliminary data from studying one woman. The transfer was very low (<0.5%), but the results won't be published until we have more samples to confirm our findings.

Kaytlin Krutsch, PharmD

[kthomps7]

Do you have any update on dexamethasone and breastfeeding?

[kthomps7]

Thank you so much! I am currently on prednisone and if I am switched to dexamethasone then I will definitely send you samples.

[admin]

Kthomps7:

The transfer of dexamethasone into human milk has not yet been published. I need to do that. Perhaps you could provide milk samples. ([url]https://www.infantrisk.com/help-infantrisk-research[/url]).

That said, corticosteroids such as dexamethasone generally penetrate milk very poorly. However, they are also known to suppress milk production in some moms. See below.

I'd suggest that with a dose this high, that you would need to be careful breastfeeding for about 2 days AFTER taking this for 4 days. The transfer of dexamethasone into milk might be enough to cause problems in your infant.

I have studied methylprednisolone following 1000 mg IV doses. In this case the levels in milk after about 12 hours were quite low and would probably not bother an infant. This mom received this dose for 3 consecutive days.

Tom Hale PhD.


Case Reports

J Hum Lact
. 2015 May;31(2):237-9.
doi: 10.1177/0890334415570970. Epub 2015 Feb 17. Transfer of methylprednisolone into breast milk in a mother with multiple sclerosis

Shaun D Cooper ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Cooper+SD&cauthor_id=25691380[/url]) ^{1 ([url]https://pubmed.ncbi.nlm.nih.gov/25691380/#affiliation-1[/url])}, Kathleen Felkins ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Felkins+K&cauthor_id=25691380[/url]) ^{1 ([url]https://pubmed.ncbi.nlm.nih.gov/25691380/#affiliation-1[/url])}, Teresa E Baker ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Baker+TE&cauthor_id=25691380[/url]) ^{2 ([url]https://pubmed.ncbi.nlm.nih.gov/25691380/#affiliation-2[/url])}, Thomas W Hale ([url]https://pubmed.ncbi.nlm.nih.gov/?term=Hale+TW&cauthor_id=25691380[/url]) ^{3 ([url]https://pubmed.ncbi.nlm.nih.gov/25691380/#affiliation-3[/url])}

• PMID: 25691380

Abstract

High-dose intravenous methylprednisolone, a glucocorticoid with powerful anti-inflammatory activities, has become increasingly important in treating acute relapses of multiple sclerosis (MS). This is a case report of a 36-year-old lactating female who was receiving a 3-day course of high-dose methylprednisolone (1000 mg IV) to treat MS. Breast milk samples were obtained at 1, 2, 4, 8, and 12 hours following a 2-hour intravenous infusion on days 1, 2, and 3. The relative infant dose was found to be 1.45%, 1.35%, and 1.15% for days 1, 2, and 3, respectively. Using the average measured concentrations (C(avg)) for days 1, 2, and 3, the estimated infant exposure was 0.207, 0.194, and 0.164 mg/kg/day, respectively, which is below the recommended dose given to neonates requiring methylprednisolone drug therapy. Infant exposure is low and mothers could continue to breastfeed if treatment with IV methylprednisolone is very brief. However, if the mother wishes to limit infant exposure further, she could wait 2 to 4 hours after IV methylprednisolone administration, thus significantly limiting the amount of drug in the breast milk.

Keywords: breast milk; breastfeeding; glucocorticoid; methylprednisolone.

© The Author(s) 2015.

[kthomps7]

What advice were you given for this question? I am wondering the same thing about dexamethasone and breastfeeding.

[apowers1120]

I have ITP and am currently 32 weeks pregnant. I plan to breastfeed but will most likely need to take steroids after I give birth to keep platelets up. I will take dexamethasone 40mg a day for 4 days probably about every 2 weeks. Will I be able to breastfeed during this time? Also, Is there any chance that my antibodies will cross through the breast milk and go to my baby causing him to have low platelets?